Rising healthcare costs frustrate and alarm consumers because they seem so out of our control.
But prescription drugs are an exception. Consumers can exercise control over costs in several areas. Here are five:
1. Ask about generic or lower-cost equivalents.
Your health plan has a formulary, a list of covered prescription drugs. Within that list are preferred drugs, which have a lower copayment cost for the patient. These are clinical or therapeutic equivalents to higher-priced brand drugs.
Always ask your prescriber or pharmacist, “Is there a generic for that?” It’s a fair question. Many physicians write for the familiar brands, the “tried and true,” or the newest, most highly marketed drug in the therapy class. Until you ask, they may not be well acquainted with lower-cost equivalents on your particular plan’s formulary.
2. Don’t be duped by drug coupons.
Hundreds of high-priced brand drugs offer coupons that apply to the consumer’s share of the drug’s cost. But beware: Copayment coupons inject waste into the healthcare system. A temporary discount can put you on a path to higher copayments and premiums.
Many patients don’t consider the extra cost to the system when offered a chance to reduce their copayment. They don’t realize that their employer could be paying hundreds of dollars more. And they don’t realize that this temporary savings may ultimately contribute to higher premiums or fewer benefits.
A recent study in The New England Journal of Medicine found that 62% of coupons were for brand-name drugs for which lower-cost alternatives were available. “Despite the short-term savings achievable with coupons, they do not offset higher, long-term costs, because they’re nearly always time-delimited,” the study said. “Some coupons can be used once and others more than once. But we found that few offered savings for more than a year. Once a coupon program ends, patients with chronic disease face copayments for these brand-name medications that are higher than for those generic alternatives.”
3. Use preferred retail pharmacies for acute medications.
Many prescription plans offer a preferred network of retail pharmacies within a wider network. These plans allow you to save between $5 and $10 on copayments just by choosing a preferred pharmacy. Chances are good that a preferred pharmacy is conveniently located near you.
Before you fill a prescription for an acute medication, such as an antibiotic or painkiller, use your plan’s pharmacy locater to find a preferred option. And inform your doctor, as he may now send electronic prescriptions directly to the pharmacy.
Medicare patients choosing a prescription plan should look for one that offers preferred networks. Savings at the pharmacy window can easily exceed any small difference in premium amount.
4. Use home delivery for chronic or maintenance medications.
With home delivery, many patients can save up to 33% on their copayment costs and have the medication delivered right to their door.
Home delivery is a safe and convenient way to obtain medications that you use long term. Many pharmacy plans will provide you with a 90-day supply for a lower copayment. Be sure to tell your doctor that you use home delivery so your prescription can be written for a 90-day supply.
There’s an important bonus that can save you even more: Patients using home delivery are more likely to take their medication as prescribed (see No. 5).
5. Take your medications as prescribed.
While it might be tempting to stretch your medication dollar further by skipping daily doses, this can be harmful to your health and end up costing you significantly more money to treat the health complications that could have been avoided.
Adherence to your prescribed therapy is the best way to make sure you get the most from your pharmacy benefit. Take your medication at the proper time and frequency as indicated by your doctor, and refill and renew prescriptions as early as possible so you are never empty-handed. Express Scripts offers mobile apps, as well as auto-refill and renewal reminder programs to help you stay on track.
VIDEO: Celeste Player, Vice President Pharmacy Practice, recently shared these tips during a television interview in St. Louis.
5 Consumer Tips
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